BGLs

Perfect Since Never

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Last week, my diabetes educator gave me a new glucose meter to try out while I think about an insulin pump (I wish there was an easy answer to that question). It’s a meter that also acts as a blood glucose logbook, and calculates my insulin doses for me instead of the usual guesstimates. Unfortunately, the new meter uses a different set of test strips. Which means that if I do decide to “adopt” this meter permanently, I have a hoard of test strips (that I’ve put a lot of effort into collecting) that are completely useless. Or, I deplete my old hoard and go weeks upon weeks before I get to finally use my new meter. Wonderful!

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On the day I began using this new meter, I accidentally ripped open one of the test strips belonging to my old meter from its foil packet. I realised before it was too late, and put the unused strip back into it’s foil packet and tucked it away for next time.

Yesterday afternoon, I decided I’d use my old meter for the “odd” afternoon test. It was around 3 in the afternoon, and I’d just come home from work. I’d had lunch and given my insulin just over an hour ago, but I had a feeling that my blood sugar level might be higher than it should be. I’d probably had a few too many carbs at lunch, thanks to the Muesli bars and Old Gold dark chocolate sitting in my locker at work.

I pulled out that test strip that I’d ripped open from it’s foil packet a week ago. I pricked my finger, applied the blood to the test strip and waited. And this was the result that came back.

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I was in shock. It had been a while since I’d seen a number that low. Normally I test often enough to stop a hypo in it’s tracks, but I’m pretty confident that I can feel one coming on. Add to that the fact that I had just driven home. I couldn’t believe it. I knew that I should have been reaching for the bag of marshmallows on my desk ASAP, but I just could not believe it. 

I was in absolute disbelief.

I ripped open a fresh test strip, and tested again.

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And instantly, everything clicked.

For five years, I’ve been ripping test strips out of their individually wrapped foil packets. Ripping them open at just the right angle, to get the right end of the strip out first to stick into the meter. Without thinking twice about it.

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But it took me until today to realise that those test strips are individually wrapped in foil packets or stored in capped vials for a reason. I guess the outside air, light and temparature can wreak havoc on the results.

I love that after 5 years, I’m still learning something new about diabetes every day.

And, also this quote from Tuesday’s #OzDOC Twitter chat, just because I think it sums up diabetes perfectly.

Happy Thursday!

My Day From The Glance of a Glucose Meter

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At 5.48, you saw me walk into the kitchen.

By 5.48, I had discovered that I was a slightly hypo 3.6. Then I walked into the kitchen.

At 6.25, you saw me eat breakfast.

By 6.25, I had calculated an insulin dose for the slice of Burgen fruit toast and Latte that I intended on having, and a fix for that hypo. Then I ate breakfast.

At 8.54, you saw me return to my work area.

By 8.54, I had checked that my blood sugar level was okay after breakfast. I had corrected that 11.3 with one unit of insulin. Then I returned to my work area.

At 10.23, you saw me come in for morning tea.

By 10.23, I had calculated an insulin dose for the banana and latte with a half sugar that I intended on having. Then, I came in for morning tea.

At 12.59, you saw me come in for lunch.

By 12.59, I had discovered that I was slightly hypo again. I had calculated an insulin dose for the Burgen bread toasted sandwich, muesli bar and 2 squares of dark chocolate that I intended on having. I had factored a fix for that hypo into my insulin dose as well. Then, I came in for lunch.

At 3.28, you saw me come out of my room after getting dressed.

By 3.28, I had discovered that my blood sugar was 5.2 after lunch, with one and a half hours of active insulin still on board. Then, I came out of my room after getting dressed.

At 4.01, you saw me go to sit outside with (another) coffee.

By 4.01, I had checked my blood glucose level once again. I had decided not to bolus for the coffee I intended on having. Then, I went to sit outside with that coffee.

At 5.57, you saw me sitting down at my desk.

By 5.57, I had sworn multiple times at my latest blood sugar reading of 19.8. I had rage corrected with 10 units of insulin. Then I went to sit down at my desk.

At 6.30, you saw me come in for dinner.

By 6.30, I had rage bolussed another 10 units for that plate of high GI risotto we were having. Then, I came in for dinner.

At 8.27, you heard me watching television in my room.

By 8.27, I had begrudgingly forced myself up to check my blood sugar level. Then I went back to watching television in my room.

At 9.29, you could hear that I was still watching television in my room.

By 9.29, I had begrudgingly forced myself up to check my blood sugar level once again. Then, I went back to still watching television in my room.

At 9.58, you heard me switch off the light and go to bed.

By 9.58, I had corrected my bedtime blood sugar reading of 4.3 with two marshmallows. Then, I switched off the light and went to bed.

At 11.59, you assumed that I was asleep.

By 11.59, my alarm had woken me up for my middle-of-the-night blood sugar check. 5.3. Then I was asleep.

Today, I did all of this without you even noticing.

Then tomorrow I’ll wake up only to do it all over again.

A CGM, and a Second Option In My Diabetes Drawer

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Two weeks ago, I attended an information evening on insulin pumps. And to a lesser degree, Continuous Glucose Monitoring. For the former, I am still deliberating. I am still plagued by two lines of thought. Will an insulin pump actually help me, and give me more ease over my diabetes management? Or will it just be the same old diabetes management but with a fancy device? And will the learning curve, and frustrations be too much to handle? I don’t know. That’s a question for my diabetes educator next week.

For the latter, however, I do have a clearer train of thought. I’ve been writing about the issue here a lot lately, and advocating for more affordable access here in Australia. And I have come to (somewhat of) a conclusion, based on my own diabetes, and my own individual circumstances.

I do not use a Continuous Glucose Monitor. For me personally, it’s estimated cost of $5,000 per year is a very large chunk of my annual salary at a time where I am looking towards my future. I would rarely spend that sort of money on myself, and I can think of a thousand other things that I would rather put that money towards.

I don’t think I could handle having access to results 24/7. I actually forced myself to stop testing so often earlier this year, because it was doing more harm to me than good. There was a time where I couldn’t handle seeing imperfect numbers. I was prematurely correcting post meal highs, only to end up hypo two hours later. Glucose numbers are always going to naturally rise after a meal. But they are going to naturally come back down as well. Sometimes I think that mentally, it’s better not to see those numbers inbetween. Out of sight, out of mind, right?

Nor do I like the idea of potentially having two devices attached to me, at a time where I am currently considering an insulin pump. I like to keep my pockets as light as possible at all times. I cannot stand jingling pockets full of crap weighing me down while I’m running around at work! Thinking about that device being attached to me all the time feels like a physical reminder of my condition. And at the moment, that feels a little demoralising to me.

Bear in mind that I have never lacked the motivation to check my blood glucose levels. I am quite comfortable checking my levels. I will sometimes test as often as 10 times a day, because it gives me a certain level of comfort. It gives me a sense of certainty, control and grounding over my condition. Without my meter I would be completely lost.

I realise that I have lived the bulk of my life with diabetes at a mature age. An age where I relish having independent control, and management over my condition. I am also still a relatively “young” diabetic, who is yet to go through a serious burnout. Perhaps my attitude towards Continuous Glucose Monitoring will change with time.

That being said, if I did have easier, cheaper access to a Continuous Glucose Monitoring device tomorrow, I would certainly take it. I would trial it. It would certainly be handy to have on me when I go on holiday, when I am frustrated, and when I just want to have a break from diabetes. It would be a useful learning tool to have, and a shield against the unpredicatability of diabetes and glucose levels.

And I am certain that every other Australian would accept glucose monitoring technology tomorrow if it were more affordable, and accessible. Either as a regular management tool, or as a second option. If you would like to see Continuous Glucose Monitoring technology subsidised by the government, I urge you (again) to write to your local Member of Parliament, and the Minister for Health, Susan Ley.

I dream of one day seeing my own Continuous Glucose Monitoring device when I open my diabetes drawer. Beside my hoard of test strips, needles and insulin pens. Sitting there patiently, as a nice second option for me to take advantage of whenever I feel like doing so.

Nightly 1am Blood Glucose Checks

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I’ve always based my decision to check my glucose levels overnight on how confident I am that they will remain stable. There have been good stretches where I have enjoyed several weeks of stable numbers through the night. And some wonderfully uninterrupted nights of sleep. Then there have also been some terrible stretches, where I have had absolutely no confidence in my glucose levels whatsoever. Which pretty much sums up the past couple of weeks for me.

I’ve been stuck in a bit of a rut these past couple of weeks. It probably started with a few days of less than perfect food choices. It would have been followed by a couple of days of less than ideal, and even harder to control, numbers. It has resulted in a lack of energy, and some unhealthy habits on my part. Like some late nights, and some extremely long weekend sleep ins. And the longer I’ve let this go on, the harder it has been for me to pick myself up and begin to climb out of this rut.

There is one thing I have done differently during this rut, however. I have taken ownership for the consequences of my unhealthy behaviour these past couple of weeks. That consequence is getting up at 1am every night to test my glucose levels. I’ve dialled up my Lantus dose to cover the added stress, fat and carbs consumed. But I’ve never really felt certain whether my glucose levels will settle, or spike again after I go to bed (mostly the latter).

There’s no worse feeling than waking up to something like 15. Or even worse, 20. It puts a huge damper on the quality of my day, and the people I interact with. I hate thinking about the fact that my glucose levels have been sitting at those crazy high levels for the better part of 8 hours. I am ridden with guilt when I think about how irresponsible I’ve been, and of all the damage that I’ve done to my body.

During this rut, I’ve managed to catch a lot of those highs at 1am and bring them back down within range by morning. I’m quite proud of that. Having control over those night time numbers has slowly restored some of my diabetes motivation. Gradually I’m getting back into my healthier habits, and my insulin requirements seem to be getting back to normal once again.

By the time I went to bed on Sunday night, I finally felt confident that my glucose levels would not rise through the night. What I did not anticipate, however, was going hypo at 1.30am. But I will still take it as a win. I just need to drop my Lantus dose a tad more, and I should be good to go once again.

Hopefully ready for the start of another good stretch.

The Diabetes Translation of “Good Thanks.”

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“Hi, how are you today?” Is what I’ll be asked the minute I walk into work this morning.

And “Haha, no too bad thanks.” Is my boring, stock standard reply that I seem to give every other day.

However, the diabetes translation of these words actually goes something like this:

Well, I wanted to have an early night yesterday. My blood sugar level was a perfect 5.3 at 9.42pm. I so badly wanted to go to bed and not think about numbers for 8 whole hours. But I couldn’t. That’s just one of the realities of having diabetes. I can do so, sometimes. But at the moment, I just can’t. I have absolutely no confidence in my night time glucose levels at the moment, which means that I can’t treat myself to a whole uninterrupted night’s sleep. I had to set my alarm last night, so that I could test my blood sugar levels during the night just to make sure.

I was startled awake at 12.30am by my favourite blaring noise that came from the alarm clock on my iPhone. My blood sugar level was another perfect 4.7, and I was able to quickly go back to sleep.

I woke up again at 2.11am, feeling a little shaky. I wanted so badly to ignore it, and drift back off to sleep. I could not be bothered opening my eyes and turning on the bright light of my bedside lamp in order to test. But I had to. I activated one of my diabetes superpowers and forced myself awake. Another perfect 4.5. I was convinced I was hypo, and had to test again just to be sure. Nope, it was 4.7. And with that, I was able to drift back off to sleep again.

I woke up next at 3.54am, feeling shaky once again. This time I was 3.1. I had to work out how many marshmallows I would treat my hypo with, and carefully measure them out onto the palm of my hand. If I don’t do this, my hypo-hangry brain will completely forget how many I’ve eaten once I start.

For the fourth time that night, I had to drift back off to sleep. And for the fourth time that night I was woken up, this time by my 5.50am morning alarm.

So, all in all, I had a crap night.

That’s what “not too bad thanks” really means, if I were to answer your question truthfully today.